ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Cardiology
This article is part of the Research TopicAdvances and Challenges in Pediatric Immune Disorders: From Pathogenesis to Personalized TherapyView all 7 articles
Homocysteine is a Risk Factor for Reduced Ejection Fraction in Children with Myocarditis:A Single-Center Study
Provisionally accepted
- 1Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing, China
- 2Capital Medical University, Beijing, China
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Background The relationship between homocysteine (HCY) and ejection fraction (EF) has been demonstrated in diseases such as coronary artery disease, but the relationship between HCY and EF in pediatric patients with myocarditis remains unclear. The aim of this study was to investigate the relationship between HCY and EF in pediatric patients with myocarditis. Methods This single-center cross-sectional study included 164 pediatric myocarditis patients aged 1-18 years, including 104 males and 60 females, at Anzhen Hospital (2023-2024) in Beijing. Patient demographic characteristics were collected, and blood tests were performed to assess HCY, routine blood tests, and markers of myocardial damage. EF was measured using 3.0T cardiac magnetic resonance (CMR), and patients were grouped using EF < 55% as the cutoff value. Statistical analyses were performed using t-tests, Binary logistic regression and Restrict cubic spline (RCS), and subgroup analyses (age, sex, body mass index (BMI)). Results Of the 164 patients, 31% (n = 51) had EF values < 55%. High HCY concentration demonstrated a statistically positive relationship with the risk of occurrence of EF < 55% (OR = 1.033, P = 0.034). Subgroup analysis showed a stronger correlation in men (OR = 1.045, P = 0.016) and in those with a BMI ≥24 kg/m² (OR = 1.083, P = 0.010). The RCS showed a non-significant trend of increasing EF < 55% (P > 0.05). Conclusion The findings suggest that elevated HCY levels are a risk factor for EF < 55% in pediatric patients with myocarditis, especially in males and overweight individuals.
Keywords: cardiac magnetic resonance, Cardiac MRI, ejection fraction, Homocysteine, Myocarditis, Pediatrics
Received: 15 Jul 2025; Accepted: 30 Jan 2026.
Copyright: © 2026 Zhang, Ren, Xu, Dong, Li, Yang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xi Yang
Guiying Liu
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